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Buckberg cardioplegia is a specialized blood-based cardioplegic solution used to induce and maintain cardiac arrest during open-heart surgery. It is designed to protect the myocardium from ischemia-reperfusion injury by providing metabolic substrates, buffering agents, and electrolytes. The solution typically contains potassium chloride (to induce rapid diastolic arrest), magnesium (to reduce calcium influx and potassium efflux), calcium (for membrane integrity), sodium (for extracellular tonicity), dextrose or mannitol (as osmotic agents and metabolic substrates), tromethamine or bicarbonate (as buffers for pH maintenance), aspartate and glutamate (amino acids that replenish Krebs cycle intermediates under anaerobic conditions). The unique feature of the Buckberg protocol is its use of both cold induction/maintenance doses followed by a warm "hot shot" reperfusion dose at the end of ischemia. This approach aims to optimize myocardial protection during periods of aortic cross-clamping in cardiac surgery[1][2][4].
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